Occipital Neuralgia (Arnold’s Neuralgia)

Occipital Neuralgia, also known as Arnold’s Neuralgia, is a condition that causes chronic pain in the back of the head, upper neck, and behind the eyes due to irritation or injury of the occipital nerves. These nerves emerge from the spinal cord near the upper neck and can become inflamed, compressed, or irritated. At Pain Consultants of East Tennessee, we offer precise diagnostic and interventional treatments designed to relieve nerve pain, reduce flare-ups, and restore comfort.

Quick facts

  • Region affected: Upper neck, back of the head, scalp, or behind the eyes
  • Common symptoms: Sharp, stabbing, or burning pain; tenderness over the scalp; pain worsened by head movement
  • Causes: Nerve irritation from arthritis, muscle tension, trauma, or compression at the base of the skull
  • Treatment goal: Relieve nerve irritation and inflammation, reduce pain frequency and intensity

Who it affects

  • Adults experiencing chronic headaches localized to the back of the head
  • Individuals with prior neck injuries, whiplash, or cervical arthritis
  • Patients with chronic tension-type headaches or migraines unresponsive to medication
  • Those experiencing scalp tenderness or sensitivity to light

How it develops

The occipital nerves—greater, lesser, and third occipital nerves—run from the top of the cervical spine through the scalp. When these nerves become inflamed or compressed by tight muscles, joint changes, or scar tissue, they send sharp or electric shock–like pain signals to the back of the head and behind the eyes. Pain may be constant or occur in episodes lasting seconds to minutes.

What to expect from treatment

Your provider will begin with a thorough history, physical exam, and diagnostic testing to confirm occipital nerve involvement. Treatment often includes:

  • Occipital Nerve Blocks: Local anesthetic and corticosteroid injections around the affected nerves to reduce inflammation and pain.
  • Medications: Anti-inflammatory, neuropathic, or muscle relaxant medications to manage symptoms.
  • Radiofrequency Ablation: Deactivates pain-transmitting nerve fibers for longer-lasting relief when nerve blocks are successful.
  • Physical Therapy: Relieves muscle tension in the neck and improves posture to prevent recurrence.

Benefits & goals

  • Rapid relief from acute nerve pain
  • Reduced headache frequency and intensity
  • Improved neck mobility and daily function
  • Long-term relief with targeted nerve therapies

Risks of untreated occipital neuralgia

  • Chronic pain and scalp tenderness
  • Worsening headaches and sleep disturbances
  • Reduced neck mobility and quality of life
  • Increased risk of medication overuse headaches

Is it right for me? (Checklist)

  • ✅ Frequent or persistent pain in the back of the head or upper neck
  • ✅ Sharp, burning, or shooting pain that worsens with movement
  • ✅ Tenderness over the occipital region
  • ✅ Limited relief from over-the-counter medications or therapy

Treatment options at PCET

FAQs

  • Is occipital neuralgia the same as a migraine? No—while symptoms overlap, occipital neuralgia is nerve-based, while migraines are vascular and neurological.
  • How long does pain relief last after a nerve block? Relief can last from weeks to months; repeat treatments may be recommended.
  • Can it go away on its own? Mild cases may improve with rest or physical therapy, but chronic irritation often requires interventional care.
  • Will I need surgery? Surgery is rarely necessary and reserved for cases that don’t respond to conservative and interventional treatments.
  • Is it covered by insurance? Most insurance plans, including Medicare, cover occipital nerve blocks and related procedures when medically indicated.

📞 Call to Schedule

If you’re suffering from chronic head or neck pain that may be caused by Occipital Neuralgia, we can help pinpoint and treat the source of your discomfort. Call us at 865-934-2567 to schedule your appointment today.